Journal Article Annotations
2021, 3rd Quarter
Annotations by Isabella Campusano, MD, Katiuska Ramirez, MD and Carlos Fernandez-Robles, MD, MBA
September, 2021
The finding:
Latina immigrant women experience multiple types of stressors that are associated with increased symptoms of depression and anxiety. The prevalence of moderate to severe depression symptoms was high in comparison to the general population, and the proportion of women with moderate to severe anxiety symptoms was higher than in other studies among Latina immigrants. While all types of stressors were associated with worse mental health, perceived stress was most strongly associated with higher levels of depression and anxiety symptoms. Social isolation and law/immigration enforcement stress were also significantly associated with depression symptoms. Stress related to meeting basic needs, such as finding and maintaining employment and affording food and rent, was associated with increased anxiety, but not depression. In terms of social supports, participants’ experience of positive social interactions was most strongly associated with decreased anxiety (but not depression).
Strength and weaknesses:
This study may not reflect the reality of all Latina immigrant women in the USA since the sample is only from western Washington State. The data also came from an intervention study, and women may have also been more likely to participate in the study if they had concerns about their own mental health. The measures of mental health outcomes (PHQ-9 and GAD-7) are both tools for screening and are not diagnostic. Surveys were administered by interviewers and may have introduced social desirability bias in participant responses. Due to the cross-sectional design, the temporal direction of observed associations cannot be confirmed.
Relevance:
The results of this study highlight important factors in the experience of depression and anxiety for Latina immigrants and the mental health burden that experience in meeting the day-to-day needs of their families, showing lights on the need for an intercultural look in these cases. Different stressors may be associated with different mental health outcomes.
The finding:
This cross-sectional study attempted to elicit Latinx or Hispanic/Latino immigrants’ (336 participants) agreement or disagreement with COVID-19-related statements added to a Spanish-language survey that was part of another ongoing study. The statements were related to immigrant access to COVID-19 testing and treatment, possible negative immigration consequences for accessing such care, and willingness to engage in contact tracing if it meant identifying an immigrant with an undocumented status. Eighty-nine participants (26.5%) agreed that uninsured immigrants can only access COVID-19-related healthcare services in hospital emergency departments, and 106 participants (31.6%) agreed that accessing publicly funded COVID-19-related healthcare services can have negative immigration repercussions. Some participants were also reluctant to identify undocumented individuals during contact tracing (96 participants when it came to identifying a household member and 114 participants when it came to identifying a co-worker). This reluctance was associated with immigrants’ history of deportation experiences as opposed to their own immigration status.
Strength and weaknesses:
A limitation of the study is that it was a non-random sample of Latinx or Hispanic/Latino immigrants since the parent study had already selected Spanish-speaking non-citizen Latinx or Hispanic/Latino immigrants, who had lived in the US for at least 6 months, were HIV negative or with an unknown status, and were sexually active. Although this may limit the generalizability of the study findings, a notable strength of this study is its efforts to gain a better understanding of an often-overlooked group’s attitudes on accessing COVID-19-related healthcare services. Additionally, the study takes into account the diversity within the study population by further analysing participants’ responses according to immigration status, number of years in the US, and history of deportation experiences.
Relevance:
Given ongoing nationwide efforts to decrease the rate of SARS-CoV-2 infection and COVID-19 morbidity and mortality as well as how the pandemic has disproportionately affected non-white groups, it is crucial to identify and provide outreach to diverse, vulnerable, and underserved communities. This study emphasizes the importance of further evaluating Latinx or Hispanic/Latino immigrants’ concerns regarding accessing publicly funded COVID-19-related healthcare services, possible negative immigration repercussions for accessing such services, and engaging in contact tracing as these concerns may further exacerbate traditional access-to-care difficulties and may lead to a delay or reluctance to engage in COVID-19 testing, treatment, and contact tracing. Additionally, this study highlights the potential benefit of optimizing liaison efforts with legal advocacy groups and community groups that have traditionally served and supported these vulnerable populations to help mitigate these concerns.
The finding:
There is a significant gap in the literature regarding the prevalence, genetics, biomarkers, and subtypes of Fronto Temporal Dementia (FTD) in Latin American countries. For instance, according to existing reports, the prevalence of FTD ranges from 1.2 to 1.7 per 1,000 people; however, this is relatively low compared to North America and Europe and may reflect under-recognition of FTE in the region.
Strength and weaknesses:
This is a well-designed review of the literature on FTD among Latin American countries: the search used both standardized terms and a flexible search strategy with input from an expert review group . Its weaknesses relate to the lack of extensive literature on the topic. Most studies are concentrated in a few countries (Brazil, Argentina, Colombia, and Chile). Given the heterogeneity in the Latin American population’s mixture of native American, European, African, and Asian migration, results may not be translatable.
Relevance:
C-L psychiatrists in the United States and Europe frequently encounter patients who migrated from Latin America. The lack of population-specific data on FTD can add to the cultural and language barriers that already complicate proper evaluation and care. This article highlights Latin American research efforts to understand the unique characteristics of this disorder in their populations. The finding of large case series’ without subsequent peer-review publication suggests there are opportunities for mutually beneficial collaboration with academic centers among North America, Europe, and Latin America. Professional societies such as ACLP are ideal networking platforms for these collaborations.